Current Status And Factors Influencing Thriving At Work Among Emergency Department Nurses:the Mediating Role Of Intrinsic Motivation

ObjectivesBased on the Socially Embedded Model and Self-determination Theory,the survey was conducted to understand the current situation and influencing factors of thriving at work of emergency department nurses from the perspectives of departmental contextual characteristics,work resources,and personal resources,and to analyze the relationship between challenge-hindrance stressors,empowering leadership,intrinsic motivation,and thriving at work;to explore the mediating role of intrinsic motivation between challenge-hindrance stressors,empowering leadership and thriving at work by constructing a structural equation model;and to provide a reference basis for nursing managers to adopt targeted interventions to improve thriving at work of emergency department nurses.MethodsA cross-sectional research design was adopted for this investigation to facilitate the sampling of emergency department nurses in six tertiary hospitals in Jinan,Shandong Province,from June to August 2022.The survey instruments were General Information Questionnaire,Thriving at Work Scale,Challenge-Hindrance Stressors Scale,Empowering Leadership Scale,and Intrinsic Motivation Scale.Data analysis was performed using SPSS 25.0 and AMOS 23.0 with descriptive analysis,independent sample t-test,one-way ANOVA,Pearson correlation analysis,multiple linear regression analysis,and structural equation model.Results1.337 emergency department nurses were included in this study,with a thriving at work score of(51.05±8.22)and the average score for an item was(5.11±0.82).Vitality dimension score was(24.68±4.54)and learning dimension score was(26.37±4.50).Challenge stressors score was(20.64±4.72)and hindrance stressors score was(13.56±3.79).Empowering leadership score was(45.51 ±9.38).Intrinsic motivation score was(75.73±12.50).2.The findings of the univariate analysis revealed that thriving at work scores of emergency department nurses were statistically significant across gender(t=2.259,P<0.05)and weekly work hours(F=4.909,P<0.01).3.The results of correlation analysis showed that challenge stressors,empowering leadership,and intrinsic motivation were respectively positively correlated with thriving at work(r=0.233～0.525,all P<0.001),and hindrance stressors were negatively correlated with thriving at work(r=-0.165,P<0.01)among emergency department nurses.4.Multiple linear regression analysis revealed that weekly work hours(β=-0.114,P<0.05),empowering leadership(β=0.380,P<0.001),intrinsic motivation(β=0.253,P<0.001),challenge stressors(β=0.220,P<0.001),and hindrance stressors(β=-0.160,P<0.01)were influencing factors of thriving at work among emergency department nurses,which together explained 40.4%of the total variance in thriving at work.5.The results of structural equation model showed that challenge stressors not only had a direct positive effect on thriving at work(β=0.259,P<0.001),but also could have an indirect effect on thriving at work through intrinsic motivation(β=0.055,P<0.01),with 95%CI[0.021,0.107]for the indirect effect,and the mediating role of intrinsic motivation in challenge stressors and thriving at work was established.Hindrance stressors not only had a direct negative effect on thriving at work(β=-0.195,P<0.01),but can also had an indirect effect on thriving at work through intrinsic motivation(β=-0.059,P<0.01),with an indirect effect 95%CI[-0.114,-0.021],and that the mediating role of intrinsic motivation in hindrance stressors and thriving at work was valid.Empowering leadership not only had a direct positive effect on thriving at work(β=0.479,P<0.001),but also had an indirect effect on thriving at work through intrinsic motivation(β=0.069,P<0.01),with 95%CI[0.035,0.119]for the indirect effect,and the importance of intrinsic motivation as a mediator in empowering leadership and thriving at work has been proven.Conclusions1.Thriving at work of emergency department nurses is at a medium level.Nursing managers should focus on this positive work experience for emergency department nurses.2.Weekly work hours,challenge stressors,hindrance stressors,empowering leadership,and intrinsic motivation are factors that significantly affect the thriving at work of emergency department nurses.Nursing managers should develop interventions to improve the thriving at work of emergency department nurses in terms of the factors influencing thriving at work.3.Intrinsic motivation respectively partially mediates the relationship between challenge stressors,hindrance stressors,empowering leadership and thriving at work.Challenge stressors and empowering leadership can both indirectly increase thriving at work by increasing the intrinsic motivation of emergency department nurses,whereas hindrance stressors indirectly leads to a decrease in thriving at work by decreasing the intrinsic motivation of nurses.Nursing managers should implement an empowering leadership style,appropriately increase the challenge stressors and decrease the hindrance stressors of emergency department nurses,and take appropriate measures to motivate nurses’ intrinsic motivation,thereby increasing nurses’ thriving at work and improving nursing quality.